MEDICARE: GREGORY A. VOSSETEIG P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	1613	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00273245	OTHER	CO	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	1220270001	OTHER	CO	DMERC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912052523
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREGORY A. VOSSETEIG P.C.

Provider Business Mailing Address
First Line	:	3501 S SHIELDS ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-2583
Country	:	US
Telephone Number	:	970-490-2020
Fax Number	:	970-221-3121

Provider Business Practice Location Address
First Line	:	3501 S SHIELDS ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-2583
Country	:	US
Telephone Number	:	970-490-2020
Fax Number	:	970-221-3121

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GREGORY A. VOSSETEIG
Credential	:	O.D.
Telephone Number	:	970-490-2020

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	04/09/2021

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